to HRT or not to HRT?

[niyre]

I’m 53, already have a mirena (have had one for over ten years so no idea what my periods are doing) and have had worsening symptoms of what I assume is menopause over the past couple of years: hot flushes, fatigue, aching joints, brain fog etc.
I know I’ve already got half HRT on board with the mirena.
Are there benefits to HRT if we can just about tolerate the symptoms of menopause?
My Mum is 91 and never used HRT. I’m just wondering if she managed with it, why can’t I?
But on the other hand, if I can feel better, more energy etc, then that’s a good thing, right?
Ive got hashimotos too, treated with levothyroxine, so as not to drip feed.

HRT all the way. It's not some kind of moral failing to give your body what it needs (oestrogen). I don't know where women have got the idea that just about managing is all you can expect out of life. You don't get any medals for being a martyr

I feel 90% better than I did before I started HRT. I highly recommend it, not just for symptoms relief right now, but for long term benefits for bones and heart health

I am in the same position (except not Hashimoto’s but I do have a chronic vestibular migraine condition). I have the lowest dose oestrogen patches to accompany the Mirena. I feel so much better with them than without, I don’t have brain fog, anxiety, sleeplessness, or hot flushes any more. Joint pain is much reduced.

Skin is clear and bright.

I’ve also lost a lot of weight with MJ, now happily maintaining on lowest dose Wegovy pills.

I’ve been able to get much fitter - strength and resistance training and walking/running/rowing machine. Nothing dramatic and I’ll never win an Olympic medal, but fitter than I’ve ever been.

The HRT is definitely part of the package that has made all of this possible. Lack of anxiety and self-doubt/sabotage is probably the biggest effect.

I’d say try them for a few months and see if you feel better. I can tell quickly if I forget to change the patch.

I agree entirely with @Lottapianos post. That's my experience too.

It's a feminist issue. Men would never put up with all this shit when there's an easily available, bio identical solution available, which aids most of the symptoms very well and protects our future heart, brain, skeletal health etc.

Be prepared to battle with GPs who love to gatekeep basic female care.. They are obliged to treat the symptoms, and you have the right to receive hrt, you might have to remind them of these facts.

'It's a feminist issue. Men would never put up with all this shit when there's an easily available, bio identical solution available, which aids most of the symptoms very well and protects our future heart, brain, skeletal health etc.'

Very well said. Men would never be expected to put up with this. And no one debates whether to start taking thyroxine if they have an under active thyroid gland, or to take insulin if they have type 1 diabetes. I know there were scary stories about HRT and cancer, but they're over 20 years out of date

Are there benefits to HRT if we can just about tolerate the symptoms of menopause?

Yes.

You know those symptoms could last for decades? My consultant mentions patients in their 80s and 90s on HRT because they still have symptoms.

Apart from the relief of symptoms, you need to take on board the benefits to bone and health.

There isn't much value in referring to your Mum. Her generation didn't 'do' HRT much at all. Is she in tip top condition or does she has heart disease or osteoporosis?

My Mum's older than 91 and I've lost count of the number of her younger friends in their 80s who've broken hips, died from heart disease etc.

HRT is believed to reduce the risk of osteoporosis, reduce the risks of heart problems, reduce the risk of developing T2D, reduce the risk of developing bowel cancer, and reduce muscle loss.

The positive effects on hot flushes, brain fog, flat mood and vaginal atrophy are a nice added side effect.

I'm 68, still taking it, and plan to take it forever.

I also have hashimotos and long standing mirena. I use HRT. No more hot flushes/ joint ache, and I sleep better.

I didn’t take it and really wish I had thought about it more carefully and started it. Even though I didn’t have an awful menopause I think I’d have had an easier time and the benefits clearly outweigh any risks.

Just to add that ther Mirena can only be used for HRT (progesterone element) for 5 years, so if yours is 10 years old, you're not getting any HRT benefit.

I plan to stay on it for as long as necessary for all the reasons mentioned above - the benefit goes above and beyond the hot flushes etc.

thanks all. I’m going to give it a go. I’ve got a telephone appointment with the menopause service of our GP surgery in a couple of weeks and hoping they don’t push back. I had my last mirena in 2023 so it’s good until 2028.
Wondering what to do post 2028 as our family planning clinic won’t do them for menopause, only for contraception, and the last GP mirena insertion I had was agony!

Good luck! I was also going to say, add in the oestrogen. It's much simpler when you already have your progesterone sorted with the Mirena.

I also had Mirena for contraception but after I had the last one removed as it had expired, they couldn't get the next one in (3 people tried), so I've been on different progestogens for several years. I also found it increasingly painful as I found out I have a retroverted uterus

Going to try again in a couple of months - luckily the community gynae service does Mirena insertions - apparently the woman who does them is the best and "if she can't do it no-one can"

You might have to look into having a private clinic do it in 2028. Shouldn't be that way but it does seem to vary HA to HA.

I love it, I don’t understand the logic of suffering needlessly just because you can.
Why not give it a go? You can always stop if you want.

Mirena It's 4 years for HRT- 5 at a push , but ideally 4.